Academic journal article Social Work

Supported Education for Adults with Psychiatric Disabilities: An Innovation for Social Work and Psychosocial Rehabilitation Practice

Academic journal article Social Work

Supported Education for Adults with Psychiatric Disabilities: An Innovation for Social Work and Psychosocial Rehabilitation Practice

Article excerpt

The value of education is so key. We must embrace learning as the path to true empowerment and effective personal and systems change.

--Paolo del Vecchio, 2001, p. 9

Dual policies of deinstitutionalization and community-based mental health services have been a mainstay of the U.S. mental health system for the past 40 years (Goldman, 1998). However, these policies have been imperfectly implemented. In the 1960s, patient populations formerly treated in psychiatric hospitals received only minimal community-based treatment in the form of medications or outpatient psychotherapy. It soon became apparent that this situation produced a "revolving door" phenomenon wherein people with serious mental illness (SMI) cycled in and out of inpatient psychiatric care (Segal, 1995). Furthermore, service providers found that the mere physical presence of people with psychiatric disabilities in the community was not sufficient for their integration into occupational, educational, or social activities (Anthony, 1994).

Helping individuals with psychiatric disabilities optimize their functioning in pursuit of desired goals requires rehabilitation methods similar to those used with physical disabilities. "Rehabilitation focuses on the reduction of disability and the promotion of more effective adaptation in the individual's environment" (Silverstein, 2000, p. 228)--so individuals can acquire skills and knowledge to minimize their disability, and environmental supports to help them carry out their rehabilitation goals. Recognition of the need for rehabilitation services and support systems as critical supplements to mental health treatment led to the development of the Community Support Program (CSP) in the 1970s. CSP launched several innovative models for psychosocial rehabilitation (PSR), including supported employment (Tice, 1994) and supported housing (Ogilvie, 1997).

One of the keys to the effectiveness of PSR programs is that they are designed as a partnership between the person with a disability and the treating professional. PSR programs focus on individual recovery through adaptation to the demands of daily life (with medical and social supports, as needed) in the usual community setting, with goals and pursuits of the consumer's choosing; individuals must be included in their own recovery. As Davidson and colleagues (2001) put it, "When people do not have hope, a sense of self-worth, and a sense of their own efficacy, they will not be equipped to take on the formidable challenges inherent in attempting to cope with, not to mention recover from their disorder" (p. 379).

Research has shown that PSR services for people with psychiatric disabilities are effective, often producing more "normalized" role functioning for the majority of service recipients (Barton, 1999). Thus, PSR is congruent with social work's emphasis on evidence-based practice. The purpose of this article is to improve awareness and understanding of one of the newest interventions in psychosocial rehabilitation--supported education (SEd)--by providing an overview of SEd principles, services, and models and information on effectiveness evaluations. We also discuss why social work should be interested in SEd.

PSYCHOSOCIAL REHABILITATION

The International Association for Psychosocial Rehabilitation Services (IAPSRS) defines psychosocial rehabilitation as:

   a constellation of services designed for persons
   with SMIs and severe functional deficits ... The
   goal is to enable individuals to compensate for,
   or eliminate, the functional deficits, and to restore
   ability for independent living, by ... teaching
   skills and coping techniques, and helping
   the individual develop a supportive environment,
   and restore a sense of mastery over his or
   her life ... PSR providers build on the strengths
   of each individual, by emphasizing wellness and
   by including families and the community in
   the recovery process (Hughes, 1993, p. … 
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